Women prefer natural birth, but then choose the caesarean

Women prefer natural birth, but then choose the caesarean

Natural childbirth is much better. But then they choose the Caesarean: is this the conclusion that emerged from the survey “Natural or Caesarean? The childbirth that divides ", conducted on a thousand interviewees (half with children and half without) by the National Health Observatory (Onda), together with the WHO (World Health Organization) and the weekly Io Donna, presented yesterday in our city .


80% of the women surveyed said they would prefer natural childbirth in order not to lose the first hours of the baby's life, to stay less in the hospital and to have a faster post-partum recovery.

Among the other reasons indicated there are also: the confidence to be able to bear the pain, the fact that no scar remains, the desire to have the father attend the birth and less difficulty in breastfeeding (in the two hours after the cesarean the newborn must stay in the incubator and therefore cannot be immediately attached to the breast).

Among the reasons that they prefer to 20% of the interviewees the Caesarean section in pole position is the "too much" fear of pain. Followed by: the possibility of planning the birth, of resuming sexual life more easily (in reality, studies say that there are no differences between the two types of birth), the child suffers less (also on this front there are no differences between natural birth and cesarean), the cesarean is safer for the health of the woman (in reality there is no evidence, indeed the cesarean can have more complications in the post).

This is the theory. In reality, the country remains at the top of the world rankings for the rate of caesarean sections which are about 40% of the births (at European levels, however, we find the province of Bolzano with just over 20%, the very black jersey instead of Campania with 60%), against the WHO recommendations of 15%.

The upward trend in Caesarean sections, it must be said, is not only Del Paesena but worldwide (OECD 2006 data). Furthermore, it is known that in some African countries, such as Ethiopia, the caesarean rate is equal to 1-2% of births, but it certainly does not signal excellence. Women in those countries do not have access to health facilities and in fact the rates of mortality and morbidity (ie of diseases) are very high.


But why is the percentage of caesareans so high in Del Paese? According to the Onda observatory, in addition to medical problems (twin birth, breech, placenta previa ...), the recourse is frequent for various reasons. In particular, because it involves less risk for the doctor, because women themselves ask for it, because there is little information (gynecologists and obstetricians should give more information on the risks for example) and because in many hospitals the epidural is still a problem. utopia.

“In choosing caesarean delivery over the natural one - underlines Francesca Merzagora, president of Onda - the woman is often unaware of the risks and contraindications that, as a surgical act, it entails. The caesarean section is therefore not only an indication of a female population that tends to give birth over the age of 40, but it signals a pathology of the system that must be corrected to reverse the tendency to a caesarean when it can be avoided or in the presence of unsuitable conditions. "

In this sense - continues Merzagora - the decision of the Minister of Health Ferruccio Fazio "to rationalize and progressively reduce birth points with less than a thousand births" should be viewed favorably, where more cesarean is used because they are less equipped to manage the problems of health of the child after childbirth.

"The results of the survey confirm that interventions already proposed in the past, such as ensuring access to the epidural for all women, could help limit the number of caesarean sections not justified by medical reasons", adds Mario Merialdi, coordinator of the Unit of maternal and perinatal health WHO.

Among the factors to be considered to explain the final choice of caesarean "we must consider the changes in customs that have occurred in the last 20 or 30 years", says Massimo Candiani, head of gynecology and obstetrics of the San Raffaele del Monte Tabor Foundation. “Today women, compared to the past, are on their way to motherhood towards the age of 40, with consequent physiological and biological difficulties that a birth at a mature age brings with it. Thus the range of women with endometriosis, uterine fibroids or who resort to assisted fertilization is widened, which in itself is a reason for resorting to a caesarean ".

“Evaluate case by case, get more information and monitor hospital structures”: This is Candiani's recipe to reduce the use of a caesarean section. And he adds: "In the Nordic countries the problem of pain has also been overcome with psychological support."

On the same wavelength Annamaria Marconi, head of gynecology at San Paolo in our city, according to whom it would be important to reduce above all "the number of first caesareans".

“There must be more dialogue between the gynecologist and the pregnant woman. The speech to be made is this: Is it a young woman who, for reasons of convenience, chooses a caesarean section or is it a 40-year-old puerpera who has resorted to assisted fertilization to get pregnant? Another thing to do is to explain what the risks of a caesarean are if you want a second pregnancy".

The San Paolo head physician also calls for more epidurals, but also a 1: 1 relationship with the midwife and suggests creating a more intimate and welcoming environment in hospitals.

Read also All About Caesarean Delivery, A Guide to Deciding, Epidural, Painless Delivery, Water Birth

For more info: Childbirth section

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